Introduction:We evaluated the safety and obstetric outcomes of patients with abnormal placental implantation who underwent prophylactic Caesarean iliac balloon insertion. Methods: Clinical and procedural records of patients with abnormal placental implantation (i.e., high-grade placenta praevia and/or placenta accreta) undergoing prophylactic Caesarean iliac artery balloon insertion in a tertiary referral hospital from September 2009 to April 2016 were reviewed. Patients' demographics, procedural complications (e.g., dissection and thromboembolism) and outcomes (estimated blood loss, transfusion requirements, immediate/delayed hysterectomy rate, postoperative sepsis, and immediate maternal/fetal mortality) were analysed. Results: Twenty-three cases were included in the study. The median age of the patients was 36 years (range, 28-47 years). A total of 91.3% (21/23) were high-grade placenta praevia (34.8% grade III and 56.5% grade IV) with 69.6% (16/23) co-existing placenta accreta. All prophylactic iliac balloon insertion procedures were uneventful without major complications such as dissection or thromboembolic events. The median blood loss was 1700 mL (100-8000 mL). The mean units of packed cells, platelets, and fresh frozen plasma transfused were 2.5, 2.2, and 2.0, respectively. The immediate and delayed hysterectomy rates were 34.8% (8/23) and 13.0% (3/23), respectively. Postoperative sepsis incidence was 8.7% (2/23). No immediate maternal or fetal mortality was recorded. Overall, the obstetric outcomes were comparable to data published in the literature. Conclusion: Prophylactic Caesarean iliac artery balloon insertion for patients with abnormal placental implantation is feasible and safe. The obstetric outcomes were comparable to data published in the literature.

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Introduction:We sought to describe focal bone lesions detected on magnetic resonance imaging (MRI) in patients following ultrasound diathermy. Methods: We performed a retrospective analysis of MRI characteristics of bone lesions in 10 patients who underwent ultrasound diathermy for musculoskeletal conditions followed by plain radiographs and MRI for pain. Magnetic resonance arthrography was performed in two patients and one patient had a second follow-up MRI examination. A phone interview was conducted with all patients. Results: All 10 patients had experienced mild to severe pain during ultrasound diathermy, with four (40%) prematurely terminating the treatment session as a result. Plain radiographs were normal. On MRI, a total of 12 lesions were observed in the 10 patients, with nine lesions in eight shoulder joints, two lesions in one ankle joint, and one lesion in the first metacarpal base. All lesions were small to medium-sized (6 × 5 × 3 mm to 32 × 23 × 9 mm), well-demarcated and subcortical in location with a crescentic or oblong configuration. Lesions were highly conspicuous on T2-weighted images and relatively inconspicuous on T1-or intermediate weighted sequences. Typically, larger lesions had a T2-hyperintense rim surrounding an isointense central area. Leakage of arthrographic contrast into the lesion was observed. The overall features favoured focal osteonecrosis in all cases. The affected locations typically had little overlying subcutaneous tissue, were close to tendon insertions, and corresponded to the site of ultrasound diathermy application in all patients. Conclusion: Appearances akin to focal osteonecrosis may result from application of ultrasound diathermy. Recognition of the characteristic appearance will allow this connection to be made to avoid subsequent unnecessary workup.